Individual provider · Type 1 NPI

Amanda Marie Ilag, AGNP

Primary Care Nurse Practitioner · Berkeley, CA

NPI number 1114745783 Active

Practice location

1901 4th St Ste 201
Berkeley, CA 94710-1986

Fax (510) 929-1414

Mailing address

PO Box 511250
Los Angeles, CA 90051-7805

Specialties and licenses

TaxonomyCodeLicense
Primary Care Nurse Practitioner Primary 363LP2300X95032119 (CA)

Primary Care Nurse Practitioner: Definition to come...

8 other providers at this address

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About NPI 1114745783

Amanda Marie Ilag, AGNP's National Provider Identifier is 1114745783, issued on Oct 1, 2024. The primary taxonomy on file is Primary Care Nurse Practitioner (363LP2300X), and the practice location is in Berkeley, CA. The record was last updated on Jan 16, 2025.